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Ethics
subspecialty of moral philosophy investigating the determinants of what constitutes right and wrong TERM 2
Fairness-Justice/Reciprocity (Pillar of morality)
DEFINITION 2 Moral rightness TERM 3
Care-Compassion/Harm (Pillar of morality)
DEFINITION 3 when there is potential for harm, people care TERM 4
Authority/Respect (Pillar of morality)
DEFINITION 4 Human communities are hierarchically structured and values have evolved where people respect and admire those who have roles of authority and leadership. TERM 5
Purity/Sanctity (Pillar of morality)
DEFINITION 5 People have an innate disgust for what is unclean. Historically, disgust with things bettered societies chances of survival. Conversely, that which is clean and pure has high values and may even be sanctified
Scholarship
discovery integration application teaching TERM 7
Principalism
DEFINITION 7 this is central to medical ethics. you can use this to evaluate medical cases TERM 8
4 Principles of Bioethics
DEFINITION 8 Nonmaleficence Beneficence Justice Autonomy TERM 9
Nonmaleficence
DEFINITION 9 first and foremost, do not harm. TERM 10
Beneficence
DEFINITION 10 Do good
Deontology
duty intent is more important than the outcome Immanual Kant-we must act from duty argues that motives alone dictate the morality of the decision, no the consequences. people are an end-in-themselves and never a means-to- an-end willing this for all based on a reason alone TERM 17
Utilitarianism
DEFINITION 17 consequences- outcome is more important than intent the decisions we make must be for the benefit of the group- minimizing pain and suffering Bentham, Mill, Hume Triage theory-give help to those who will benefit most from it and leave this with "no hope"out. potential problem:egoism-maximizing benefits for one's self everyone counts and counts equally if we are dealing with public health, utilitarianism is probably the best choice TERM 18
Laws
DEFINITION 18 Rights-the least we can expect from each other bottom-up-theory-helping those at the bottom is best for everyone-create universality and build up from there social contracts right are a claim and claims must be justified Hobbes, Locke, American Founding Fathers with each right comes responsibility TERM 19
Existentialism
DEFINITION 19 personal responsibility-we have a free will and are responsible for the choices we make we are responsible for both the good and the bad ex:cigarettes, heroin, immunizations Christian ethics-Kiekegaard jewish philosopher-Buber athiest-Sarte, Camus TERM 20
Feminist Ethics
DEFINITION 20 care-women are equal to men Simone DeBeauvoir-Feminist existentialism and feminist theory Carol Gilligan-"in a different voice" Hannah Ardent-the banality of evil
Eudamonia
Happiness; Human Flourishing TERM 22
Natural Law
DEFINITION 22 comparing things to how they happen in nature TERM 23
Ayn Rand
DEFINITION 23 "The virtue of selfishness" TERM 24
Psychological Egoism
DEFINITION 24 people really do make decisions that they think will maximize benefit for themselves. TERM 25
Ethical Egoism
DEFINITION 25 individuals should/ought to make decisions that they think will maximize benefit for themselves."Looking out for number one"
COBRA
1985 passed by congressallows coverage 18 months after termination from a company at the same rates as the employed, but the employee must pay both shares TERM 32
HIPPA
DEFINITION 32 H ealth I nsurance P rivacy and P ortability A ct 1996prevents exclusion due to pre-existing condition TERM 33
Cost Shifting
DEFINITION 33 An economic situation where one individual, group, or government underpays for a service, resulting another individual, group or government overpaying for a service TERM 34
Medicare
DEFINITION 34 "cares for the elderly" 1965 Johnson age 65+, End Stage Renel Disease patients and some people with disabilities federal government covers about 80% of medical expenses financed with mandatory payroll taxes-FICA TERM 35
Medicaid
DEFINITION 35 "aids the poor" 1965 Johnson AKA:entitlement covers the poor, especially those on public assistance and adults with mental illnesses varies from state to state will cover nursing home care-medicare does not pays for medications for mentally ill patients- ex: schizophrenia
ACA
A ffordable C are A ctobama 2010the acts ultimate goal was covering all americans and making medical costs reasonablehasn't covered everybodystep in the direction of healthcare being a right. still a debate TERM 37
Experienced Rating
DEFINITION 37 if you have a pre-existing condition, I could choose not to insure you at all or I could charge you a premium you couldn't afford (better for insurance) TERM 38
Community Rating
DEFINITION 38 Put everybody in the risk pool regardless of your health status, charge the same to every policy holder in that group (better for policy holder) TERM 39
CHIP
DEFINITION 39 State C hips H ealth I nsurance P rogram designed to cover those who make too much money for government assistance, but not enough to be able to afford healthcare for their children covers check-ups, prescriptions, dental, and eye care reverses the incentive for not working mohave Medicaid cover cost TERM 40
CHAMPUS/Tricare/VA Hospitals
DEFINITION 40 provides medical care for veterans CHAMPUS and Tri-care -for active duty people, only covers medical necessity VA-covers surgery, drugs, physician visits, mental illness and on term care
Massachusetts
tried universal healthcare along with Vermont Specifically penalized noncompliance poorest people were not charged premiums or deductibles TERM 47
Vermont
DEFINITION 47 along with Massachusetts tried universal healthcare rather than penalizing noncompliance, Vermont encouraged additional programs covered screening, counseling and prevention for people Problem:not enough primary care physicians TERM 48
HMO
DEFINITION 48 H ealth M aintenance O rganizations 1970s Nixonmake insurance competing compete against each other TERM 49
BCBS
DEFINITION 49 B lue C ross B lue S heildcommunity ratinginsured everyone in a state who wanted insurance TERM 50
Genetic Testing
DEFINITION 50 testing in advance for diseases who's symptoms may take several years to surfaceex: Huntington's disease, Alzheimer's, diabetes type II, Breast cancer
Nancy Wexler
Ph.D Neuropsychology at risk for Huntington's disease she was a scientist working to find the gene for Huntington's disease and a predictive test discovered a linkage test which was around 80% accurate big advocate for the test until she discovered it and then changed her mind and became an advocate for people to not take the test 1993- the exact gene location was found, but Nancy remained against the test and helped create a drug to ameliorate symptoms Genetic and disease testing TERM 52
Eugenics Movement 1905-
DEFINITION 52 the belief and practice of improving the genetic quality of the human race-BAD science although associated with Europe, the headquarters were in America Eugenics and Social Darwinism contradicted themselves sterilization Immigration Restriction Act of 1924 several false assumptions and false statements about the practice of Eugenics Positive: knowing the mistakes about Eugenics movement can help us see the mistakes today with policy on genetics genetics ended this movement the people at the top saying they are at the top for a reason because of Darwinism "survival of the fittest"a form of racism----gave way to genetics----gave way to epigenetics TERM 53
Sterilization
DEFINITION 53 people were sterilized against their will and for very vague reasonsEx: Buck vs Bell- Carrie Buck was supposedly mentally retarded and committed at age 18, she was pregnant at the time. Because they found her immoral and mentally retarded, they sterilized her TERM 54
Immigration Restriction Act of 1924
DEFINITION 54 denied entry of people from "inferior countries" TERM 55
Testing For Huntington's Disease
DEFINITION 55 of note: everyone who has the gene for Huntington's disease WILL get the symptoms regardless of health, socioeconomic status or life choices
Ethical Issues Surrounding Genetic Testing
Personal responsibility testing as self interest testing only to hear good news testing as a duty to one's family testing ones family by testing oneself testing and sick identity preventing suicide by not knowing testing only with good counseling genetic testing and insurance premature announcement and over-simplification making money from genetic testing blame and responsibility TERM 62
Personal Responsibility (Ethical Issue)
DEFINITION 62 when a disease has both genetic and environmental components how responsible is the person for getting the disease if a person is tested and know that they are at risk for a disease with also know environmental factors-it may be partly their fault is no precautions are taken if a person takes precautions and still gets the disease, it is more about the genetics and less personal responsibility TERM 63
Testing As Self Interest
DEFINITION 63 test to help with preventative care when possibleEX: if you know you are predisposed for diabetes- eat right and exercise TERM 64
Testing Only To Hear Good News
DEFINITION 64 people want the test to hear that they don't have the disease and are not always prepared to hear the contrary news people can never know how they will react to bad news TERM 65
Testing As A Duty To One's Family
DEFINITION 65 you don't want to pass the disease to your children families and caretakers want to know what they are in for to plan the future
Testing One's Family By Testing
Oneself
positive testing in one's family member means higher positives or higher risks for other family members other family members have a right to not know also TERM 67
Testing And Sick Identity
DEFINITION 67 people could adopt a "sick identity" and become sick long before actual symptoms highly suggestible people TERM 68
Preventing Suicide By Not
Knowing
DEFINITION 68 argument that people will be more likely to commit suicide after finding they are positive for disease we are preventing suicide by not letting them know contrary: Nancy Wexler claims that knowing they have the option for suicide, Huntington's patients regain a sense of control over their lives TERM 69
Duty
DEFINITION 69 Intent to deliver best preventative care TERM 70
Utility
DEFINITION 70 Help the most/flourish/prevent/minimize harm
GINA
G enetic I nformation N ondiscrimination A ctbans insurers from using knowledge about one's gene to determine eligibility for insurance or increasing rates this does not apply to people applying for disability or long term care coverage TERM 77
Premature Announcement And Over-
Simplification
DEFINITION 77 genetic connections are made and disproven frequently we need to be cautious because predisposition can lead to sick identity, even if the connection is later disproven TERM 78
Money Making From Genetic Testing
DEFINITION 78 people could be wasting their money getting genetic tests because they were never predisposed to begin with, they just wanted the test this could benefit people: Positive result: person can practice preventative medicine negative result: person has peace of mind we must also account for genetic fatalist- people who think "to hell with it, i have this predisposition, I'm going to live recklessly because i am going to die anyway" TERM 79
Blame And Responsibility
DEFINITION 79 we must be careful in laying blame to people with genetic predisposition to diseases with environmental factors as well we don't know what they are going through ex: perhaps the predisposition also makes them crave sugar more strongly than others we must avoid simplistic genetic fatality and simplistic moralism TERM 80
BDNF
DEFINITION 80 B rain D erived N eurotrophic F actorexercise increases this
DALY
D isability A djusted L ife Y ears1. Harvard School Public Health2. World Bank3. World Health Organization TERM 82
Circumstances
DEFINITION 82 When we look at circumstances and we look at who has power, we look at who's best interest do the circumstances fit TERM 83
History of AIDS and The Disease
DEFINITION 83 Beatrice Hahn used DNA testing to prove that HIV spread to humans from wild chimpanzees in Cameroon gay men first started showing signs of the disease and it was initially named GRID initially blood samples could have been tested for HIV, but it was deemed to expensive and "dirty" blood was given out for a long time transmission Kills your CD4 lymphocytes T4 cell count below 200 then opportunistic infections can set in AZT TERM 84
GRID
DEFINITION 84 G ay R elated I nfectious D isease TERM 85
AZT
DEFINITION 85 zidovudine-drug which decreased the transmission of HIV from mother to baby down to only 1%.also helped people with HIV manage the disease-no a cure though.protease inhibitor
CDC
center for disease control TERM 92
3 Ethical Issues In Stopping The Spread of HIV
& AIDS
DEFINITION 92 Homosexuality Needle Exchange Programs HIV Exceptionalism TERM 93
Homosexuality
DEFINITION 93 there is still stigma around homosexuality and to educate the homosexual community more so than any other community continues to stereotype of blame TERM 94
Needle Exchange Programs
(NEP)
DEFINITION 94 gives clean needles and syringes to drug users so they always have clean utensils and do not mix blood with other people does this condone drug use? will this increase the number of users because of ease of attaining the needles and syringes TERM 95
HIV Exceptionalism
DEFINITION 95 HIV exceptionalism is the term given to the trend to treat HIV/AIDS differently from other diseases, including other sexually transmitted, infectious, lethal diseases in law and policy. initially it was not mandated that people at risk for HIV get tested now you do not have the right of confidence with infectious diseases like HIV-contact tracing is legal later tracing mandated
Nushawn Williams
Nushawn Williams (born November 1, 1976), also known as Shyteek Johnson, is an American convicted sex offender who admitted in 1997 to having unprotected sex with numerous girls and women after having been told that he was HIV positive.preventing global spread of AIDS TERM 97
Stopping Worldwide Spread Of HIV
DEFINITION 97 Education prevention feminism triage structuralism TERM 98
Education Prevention
DEFINITION 98 teach preventative behavior ex: Thailand-educated all its people in multiple different ways through multiple different medias and decreased the spread by 80% ex: Brazil-popular sex trade business in Brazil and education and availability of anti-AIDS drugs helped decrease the spread most effective result TERM 99
Feminism
DEFINITION 99 "Let's empower women"we need to empower women to prevent themselves from getting infected by giving them the vote, allowing them to earn money and reject domestic violenceOF NOTE: some men in Africa believe that a cure for HIV is to have intercourse with a virginsoldiers use rape as a weapon TERM 100
Triage
DEFINITION 100 we should help the countries who want to help themselves and forget about the countries who are not helping themselves (Africa) or don't need our help (America) emphasis on personal responsibility- if they don't want to help themselves they will not take help from us admit that deaths will happen, but those who survive will pass on god health practices to their offspring-darwinian evolution some may be a "lost cause". put effort toward maximizing good and minimizing harm (mostly toward women and children) writing off whole countries
